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Description
Depression is a psychiatric disorder that causes a persistent feeling of sadness and loss of interest. Depression affects mood, behavior and overall health. It is also called major depressive disorder or clinical depression. The main symptoms of depression are caused due to the functional deficiency of the brain monoaminergic transmitters norepinephrine (NE), 5-HT and Dopamine. Treatment-resistant depression (TRD) is a term used in clinical psychiatry to describe a condition that affects people with major depressive disorder (MDD) who do not respond adequately to a course of appropriate antidepressant medication within a certain time.
Ketamine was first introduced in Belgium in 1960s as an anesthetic medicine for animals. FDA approved it as an anesthetic for people in 1970. Recently the drug’s potential as a treatment for depression and antidote to suicidal thoughts has drawn researchers’ attention. Ketamine comes in several forms. The only one that the FDA has approved as a medication for depression is a nasal spray called Esketamine (Spravato). It’s for adults who either haven’t been helped by antidepressant pills, have major depressive disorder, or are suicidal. The mechanism of Ketamine effects is mainly related to its inhibition of the NMDA receptor and its pathway. It has the potential to become a first line anti-depressant medication, especially for refractory major depression, as well as in suicidal ideation and OCD. Ketamine is a part of treatment but not the entire treatment. People need to psychotherapy to help make sense of what the change means for them in their lives.
Keywords: Depression, Major Depressive disorder, Treatment Resistant depression, Ketamine, Antidepressant